the national strategic plan for tuberculosis and leprosy control

THE NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS AND LEPROSY CONTROL (2010-2015)

Federal Republic of Nigeria

Recommended Citation: Federal Ministry of Health of Nigeria. February 2011. The National Strategic Plan for

Tuberculosis and Leprosy Control (2010-2015). Bethesda, MD: Health Systems 20/20 project, Abt Associates Inc.

February 2011

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I I I I I I I

I I I I I I I I I

The National Strategic Plan for Tuberculosis & Leprosy Control (2010-2015) i

better systems, better health

THE NATIONAL STRATEGICPLAN FOR TUBERCULOSISAND LEPROSY CONTROL(2010-2015)

February 2011

This publication was produced for review by the United States Agency for International Development. It wasprepared by (Add all authors names) for Health Systems 20/20 Project.

DISCLAIMER: The author’s views expressed in this publication do not necessarily reflect the views ofthe United States Agency for International Development (USAID) or the United States Government

ii

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The National Strategic Plan for Tuberculosis & Leprosy Control (2010-2015) 01

According to WHO, the CDR is calculated as the number of new smear-positive cases notified divided by the number of new smear-positive cases estimated for that year, expressed as a percentage (http://www.who.int/whosis/indicators/2007TBCasesDetectedDOTS/en/index.html).



Zankli Medical Center, Abuja

10 16 9 11 46

NIMR, Lagos 0 0 9 13 22DFB 0 29 5 4 38Total 10 42 23 18 107

Note: NIMR=Nigerian Institute for Medical Research, DFB=Damien Foundation Belgium

Reporting Institutions

Notified MDR TB Cases Total

2006 2007 2008 2009

TABLE 1. PREVALENCE OF MDR-TB

FIGURE 1. NATIONAL TREND OF TB CASES NOTIFIED,* 2002-2008

19,69928,173

33,755 35,08039,903

44,016 46,026

31,164

46,473

59,49366,897

73,854

86,24190,311

-

20,000

40,000

60,000

80,000

100,000

2002 2003 2004 2005 2006 2007 2008

TB c

ases

not

ified

NewSm+

Allformof TB

* “Notified” cases have been first diagnosed, then reported to the national disease control center, and then reported to WHO.

FIGURE 2. NEW LEPROSY CASES IN NIGERIA AND WORLD, 2002-08


Note: *100 : Global numbers shown are in multiples of 100.

7,000

6,000

5,000

4,000

3,000

2,000

1,000

0

2002 2003 2004 2005 2006 2007 2008

Global *100

Nigeria

Tuberculosis

Pursue high -quality DOTS

expansion and

enhancement

Increase TB case detection rate from 30.5% in 2008 to 70% by 2015, aligning

with the WHO target.

Increase treatment success rate from 82% in 2008 to at least 85% by 2015.

Strengthen the exi sting PSM system in order to ensure uninterrupted drug and

commodities supply in all TB and leprosy (TBL) facilities throughout the plan

period.

Strengthen the Supervision, M&E system at all levels to ensure that at least 95%

of all planned activities are implemented effectively and efficiently.

TB/HIV collaborative

activities

Increase and sustain the proportion of TB patients tested for HIV from 62% in

2008 to at least 85% by end of 2015.

Ensure that at least 85% of TB/HIV co-infected patients receive CPT.

Ensure that at least 85% of eligible TB/HIV co -infected patients receive

antiretroviral therapy (ART).

Establish infection control in all health care facilities providing both DOTS and

ART services.

Establish MDR-TB services

Establish a routine drug resistance surveillance system by the end of 2011.

Ensure that all Category 2 failures have access to lab diagnosis services for MDR

by end of 2012 and all Category 1 failures by end of 2015.

Provide second-line anti-TB drugs for at least 85% of d iagnosed MDR cases by

end of 2015.

Engaging all care providers (PPM): Strategic alliance with academic, private and other public practitioners.

Scale up PPM services within the private, military, paramilitary, police, prisons,

and customs health services such that it contributes to at least 15% of total TB

cases detected (excluding those from tertiary health facilities) by the end of

2015.

Expand Hospital DOTS Linkage (HDL) to all tertiary health institutions by 2015.

Engaging communities and

patients in TB activities

Establish community TB care (CTBC) activities in at least 5 LGAs per state by

end of 2015.

ACSM Improve community awareness on TBL such that at least 60% of the public are

aware of signs and symptoms of TBL and TBL service points by end 2015.

Ensure budgetary allocation and release of annual funds for TBL activities at all

levels.


Strategies Specific Objectives

Leprosy

Early case detection Reduce the rate of new cases with grade-2 disabilities by at least 35% by the end

of 2015, compared to the base line at the end of 2010.

Ensuring case holding Sustain MB and PB (Paucibacillary) treatment completion rate of at least 85%

and 95% respectively throughout the plan period.

Prevention of disability Ensure quality patient care such that the proportion of patients who deve lop

new/additional disabilities at the end of treatment is not more than 5% annually.

Comprehensive

rehabilitation services

Set up a systematic rehabilitation service aimed at empowering persons affected

by leprosy, using community -based rehabilitation systems in all states by end of

2015.

Research and HRD

Research Develop and strengthen capacity for research on TB, TB/HIV, and leprosy at all

levels.

HRD Develop the management and leadership capacity of program managers at all

levels by end 2015.

Ensure that the human resource needs of TB and leprosy services at all levels

are met (recruitment, retention and motivation).

Develop and provide all program tools (guidelines, manuals and recording &

reporting forms) for effective implementation of TB and Leprosy Control

Program.

Empower health care workers to provide comprehensive TL services through

training in all components of Stop TB strategy and enhanced global strategy for

leprosy.

Establish and maintain health information management system for human

resources for NTBLCP.



2 The EHF (Eyes, Hands, Feet) score is a measure of severity and disability.

collaborative activities nationwide. USAID has been actively involved in 17 states in the

northern part of the country, including Lagos and the FCT. USAID is also supporting the MDR-

TB survey and implementation of MDR -TB activities, includi ng strengthening the zonal and

national reference laboratories. USAID is also supporting the national TB logistic systems,

community TB care, Public -Private Mix (PPM) -DOTS, and ACSM, and is strengthening the

health system through renovation of facilities, human capacity building, and supply of

microscopes and laboratory commodities. USAID has supported the development of a costing

tool for provision of TB services, NTP strategic plan, and HRD plan 2010 −2015 and is

strengthening supportive supervision through the use of personal digital assistants (PDAs).

WHO Technical support in policy formulation, strategic planning, supervision, monitoring, and

program evaluation at national and state levels. Resource mobilization and supply of anti -

leprosy drugs.

Centers for Disease

Control and

Prevention (CDC)

Supporting IPs to provide TB/HIV collaborative activities in all the states of the federation and

FCT. Support for the National MDR -TB survey and for diagnosis and management of MDR-TB,

including culture, drug sen sitivity test (DST) and polymerase chain reaction for line probe

assay. QA system.

Damien Foundation

Belgium (DFB)

Supporting TB and leprosy control in two states of S/W Nigeria (Oyo and Osun): provision of

anti-TB drugs, lab reagents/consumables, trainin g of health staff, and supervision. Supporting

the MDR -TB Treatment Center at UCH -Ibadan (culture and DST, training, cost of patient

management)

German Leprosy and

TB Relief Association

(GLRA)

Supporting TB and leprosy control in 14 states in S/E, S/W, an d S/S Nigeria (Abia, Akwa Ibom,

Anambra, Bayelsa, Cross River, Delta, Ebonyi, Edo, Ekiti, Enugu, Imo, Ondo, Ogun, and Rivers):

Provision of anti -TB drugs, microscopes, project vehicles, and general logistics (to 2006); lab

reagents/consumables, training of health staff, and supervision. TB/HIV project in Lagos: co -

ordinates ILEP support to leprosy control in Lagos state; piloted PPM in Anambra and Abia;

operational research in TB, TB/HIV and leprosy; pilot project in Buruli Ulcer control in Cross

River State.

Netherlands Leprosy

Relief (NLR)

Supported TB control in four states in N/C and N/E Nigeria (Bauchi, Gombe, Kaduna, and

Plateau): provision of anti -TB drugs, lab reagents/consumables, training of health staff and

supervision (to 2006). Supporting 13 st ates in leprosy control (Adamawa, Bauchi, Benue,

Borno, Gombe, Jigawa, Kaduna, Kano, Katsina, Nasarawa, Plateau, Taraba, and Yobe):

provision of logistics (vehicles and motorcycles) for TB control in combination with leprosy.

The Leprosy Mission

Nigeria

Supporting leprosy control in seven states of N/C and N/W Nigeria (FCT, Kebbi, Kogi, Kwara,

Niger, Sokoto, and Zamfara). Partly supporting TB in those states with respect to training of

state and LGA TBL supervisors and technical support in field supervision.

Private Health Care

Providers

Provide service for profit (mainly clinical care). Current piloting to determine public -private

sector mix in TB control.

Abt Associates Inc.

Partnership for Transforming Health Systems 2 (PATHS2): Designed to facilitate efficient use of

Nigeria’s resources to attain the MDGs through improving the planning, financing, and delivery

of sustainable and replicable pro -poor health services for common health problems in specific

locations (Enugu, Jigawa, Kaduna, Kano, and two o thers to be determined).

Health Systems 20/20:

In collaboration with the Ministry of Health, piloting supportive supervision using PDAs

National TB Services Improvement via Human Capital Development: Costed Plan

Continued Improvement and Application of the Nigeria TB Direct Costing Tool

Improved diagnostics for TB, in collaboration with Tulane University: will provide technical

assistance to Zaria TB Institute to improve TB diagnostics (e.g., for under -diagnosed pediatric

TABLE 3. MAJOR TECHNICAL AND FINANCIAL PARTNERS OF NTBLCP


Stakeholder Area of Work

USAID Support for the establishment and expansion of TB DOTS services in 17 sta tes, and TB/HIV

TB), with the new Microscopic Obs ervation-Drug Susceptibility (MODS) technique for culturing

Mycobacterium tuberculosis.

Strengthening TB laboratory capacity, in collaboration with the South African Medical Research

Council (SMRC): will support Zaria to enhance laboratories' diagnostic a nd management systems

by updating manuals/guides; creating a new overall framework for managing TB laboratory

networks; helping to train laboratory personnel in new guidelines and frameworks; and introducing

modern methods for TB detection and treatment, s uch as LED microscopy.

Establishing systems for systematizing and harmonizing laboratory quality assurance

JSI Deliver

(USAID |

DELIVER

PROJECT)

Providing technical assistance and capacity building in logistics management of TBLCP commodities.

Main focus is on central -level capacity building, with support to Logistics Unit and NTBLTC in

system development and implementation of capacity building for health care workers HCWs.

Provision of technical support for implementation of Procurement and Supply managem ent

functions with the NTBLCP, including national -level quantification, supply planning, and inventory

management.


ANNEX A. LOGFRAME FOR TBL STRATEGIC PLAN 2010-2015

The following table shows the objectives and activities for each thematic area, along with

the objectively verifiable indicators (OVI) and means of verification (MOV) for each

objective and activity.

Objective 1

1.1 Increase TB case detection rate from

30.5% in 2008 to 70% by 2015.

1.2 Increase treatment success from

82% in 2008 to 85% by 2015.

Case detection rate of new

smear positive cases

Treatment success rate

Quarterly and annual report on TB case finding at LGA, state, zonal and national levels

Main activities:

1.1 Establish 2,346 additional DOTS

treatment centers

1.2 Support renovation of both old and new

DOTS treatment centers (5,088)

1.3 Establish 1,247 addition AFB microscopy

centers

1.4 Support renovation of both new and old

AFB microscopy centers (2,216)

1.5 Upgrade and maintain the reference

laboratories (2 national and 6 zonal

laboratories)

1.6

Establish TB/HIV services in at least 70%

of eligible PPM facilities by 2015

1.7

Scale up HDL plan in all tertiary health

facilities by 2015

1.8

Establish DOTS services in at least 85%

of Nigerian prisons

1.9

Provide first-line anti TB drugs, reagents,

etc. (see section on PSM)

1.10 Support contact investigations of

symptomatic contacts and children less than 6 yrs within treatment facilities in 36 states and FCT

1.11 Develop and distribute cough signage for

all DOTS Treatment centers

1.12 Training activities (refer to section on HRD)

Outputs:

1.1.

2,346 additional DOTS

treatment centers established

1.2 5,088 DOTS treatment

centers for DOTs renovated

1.3 1,247 new AFB microscopy

centers established

1.4 2, 216AFB microscopy

centers renovated

1.5 2 national and 6 zonal

reference laboratories functional

1.6 (a) TB/HIV services available

in 70% PPM sites (b) Proportion

of cases detected attributable to PPM

1.7 All tertiary health facilities

have HDL

1.8 85% of Nigerian prisons

providing TB services

Objective 2

Strengthen the existing PSM system in order to ensure uninterrupted drugs and commodities supply in all TBL facilities throughout the plan period.

Proportion of health facilities

reporting ‘no stock-out’ of all anti-TBL drugs and other

Quarterly and

annual reports and logistic

commodities assessment tools

Objectives and Activities OVI MOV


Pursue high-quality DOTS and enhancement

Strengthen PSM

Main activities:

2.1 Renovation and annual maintenance of

national, 6 zonal and 37 states stores

2.2 Procurement of both 1st and 2nd anti-TB

drugs for estimated number of patients

2.3 Support commodities clearance and

transport to different levels

2.4. Procurement of laboratory reagents and

consumables for 2, 216 AFB microscopy

centers (old & new centers)

2.5 Procurement of reagents and other

consumables for culture, DST and line probe assay for the 2 national and 6 zonal reference laboratories.

2.6 Procurement and installation of

equipments for the 2 national and 6 zonal

laboratories.

2.7

Procurement of microscopes (light, LED

and FM) for the additional laboratories as

appropriate (1,247)

2.8

Procurement of Isoniazid for prophylaxis

among children and PLHIV (4,000 clients).

2.9

Procurement, installation and

maintenance of X-ray machines (at least one per state) for diagnosis of TB in children and EPTB

2.10 Procurement of Rifabutin for TB/HIV

co-infected patients on 2nd line ARVs (estimate 2-5% of total TB/HIV co-infected cases)

2.11 Procurement of Cotrimoxazole for

CPT

among TB/HIV co-infected patients at DOTS centers (27-40% co-infection rate)

2.12 Procure and support maintenance of TB

infection control equipment (N95 respirator, vaneometer, surgical mask, etc.)

2.13 Replacement and maintenance of project

vehicles and motorcycles at various levels.

Outputs:

2.1 Functional stores at all levels

Annual reports at all levels

2.3 Drugs available at appropriate levels in adequate quantities

2.4 Reagents and other

consumables procured

2.5 Reagents and consumables

for NRL and ZRL procured

2.6 Equipments for NRL and ZRL

installed and functional

2.7 Microscopes for 1,247 AFB

micros copy centers procured

2.8 Isoniazid

procured for 4,000

clients per year

2.9 X-ray machines installed and

maintained in each state

2.10 Rifabutin procured for –1,341

patients annually

2.11 Cotrim for CPT procured

for 26,822 patients annually

nd2.2 1st and 2 line anti-TB drugs

procured

2.14 Procurement of MDT and other drugs/ POID materials for leprosy patients (using an average of 5,000 patients annually).

2.15 Organize quarterly meeting of TBL

logistics technical working group (TWG)

2.16 Conduct annual stock-taking for TBL Drugs and other commodities by national and zonal logistics officers.

2.17 Procure laptops for state M&E officers and LGA supervisors

2.12 IC materials and equipment

available in all health facilities with DOTS services

2.13 8 vehicles and 155 motor-cycles replaced and maintained annually

2.14 MDT drugs, POID materials

procured.

2.16 # of laptops procured and

distributed

2.15 Quarterly meetings for

logistics TWG conducted

Objectives and activities OVI MOV



Objective 3.1

Main activities:

3.1.1 Organize and conduct situation

analysis to establish baseline data for some of the program indicators.

3.1.2 Develop, produ ce, and disseminate an

indicator reference book for the NTBLCP

3.1.3 Conduct annual data audit on key

indicators

3.1.4 Conduct a stakeholders meeting for harm-onization of work plans at national level.

3.1.5 Develop annual work plans with a

costed budget at national level

3.1.2 Quarterly supervision to

states conducted and reported

3.1.3 Quarterly supervision to

LGAs conducted and reported

3.1.4 Fortnightly supervision to health facilities conducted and reported

3.1.5 Bi-annual supervision to national and zonal reference labs conducted and reported

3.1.6 Quarterly meetings conducted at zonal levels

3.1.7 Quarterly meetings

conducted at state levels

3.1.8. Quarterly planning cell

3.1.6 Plan and conduct quarterly Program Review Meeting at the 37 states

3.1.7 Support conduct of quarterly zonal

review meeting

3.1.8 Plan and conduct quarterly planning

Strengthen the M&E system at all levels in order to ensure that over 95% of planned activities are implemented, monitored and evaluated in line with the National Strategic Plan 2010−2015.

Percentage of planned

activities implemented at

national, state, and LGA level

Outputs:

3.1.1 Supervisory visits conducted


meetings conducted

3.1.9 Annual control officers

meeting held

3.1.10 Mid- and end-term

evaluation conducted

3.1.11 Annual program

monitoring mission conducted

3.1.12 # of health facilities

supervised monthly by TBLS

3.1.13 # of LGAs supervised by

State TBLCO

3.1.14 # of supervisory visits

conducted by NTBLCP


conducted to states by NPOs


conducted by central unit zonal coordinators

3.1.17 Monthly review meetings

conducted

cell/coordination meeting at national level

3.1.9 Plan and conduct annual program review meeting with state program officers and partners

3.1.10 Plan and conduct midterm evaluation of the TBL strategic plan

-term and end

3.1.11 Conduct biennial Program monitoring and periodic evaluation (Joint Inter-national Monitoring Mission)

3.1.12 Plan and conduct program-integrated

supervision to all TBL health facilities monthly by LGA TBLS

3.1.13 Plan and conduct program-integrated sup-ervision to all LGAs quarterly by State TB and Leprosy Control Officer (STBLCO)

3.1.14 Organize supervision from national/zonal officers to state TBL Control Programs at least 12 states per quarter

3.1.15 Plan and conduct program-integrated supervision to all states bi-annually by National Program Officers Support central unit zonal coordinators to provide technical assistance through supportive supervisory visits to 3 states per quarter

3.1.17 Organize a monthly coordination meeting of all units at the national levels

3.1.16

Strengthen M&E


Objective 3.2

Institute and strengthen electronic data

management system at all levels (facilities, LGAs, states, and national).

#/proportion of management

units with electronic data

management system in pl

ace

Program reports

Activities:

3.2.1 Identify and engage a technical assistant

(TA) for the development of a database for

NTBLCP

3.2.2 Conduct situation analysis, inventory

and IT assessment at the national, states

and LGA level for M&E

3.2.3 Develop IT specification for IT

requirements at all levels

3.2.4 Develop a suitable software for data

management at all levels

3.2.5 Procure and distribute IT infrastructure

to all the points of need at all levels (including laptops)

3.2.6 Support maintenance of the IT

supportive structures/ national website

3.2.7 Provision of regular feedback on

completeness and quality of data transmitted at all levels

Outputs:

3.2.1 Database for NTBLCP

developed

3.2.2 IT situation analysis

conducted

3.2.3 IT specificatio ns developed

for various levels

3.2.4 Software for data manage-ment developed at all levels

3.2.5 # of IT materials procured

and distributed

3.2.6 IT supportive

structure/web site maintained

Objective 3.3

Build capacities in M&E, strategic

information (SI), and data management

for the program at all levels (health

facilities, LGAs, states, and national) by

2015.

#/proportion of health

workers trained on M&E, SI,

and data management

system

Activities:

3.3.1 Review the National M&E training

curriculum/module

3.3.2 Organize a training of trainers (TOT)

for the M&E course

3.3.3 Train all the LGA TBLS on M&E and

Health Facilities

3.3.4 Develop SOP and checklists for data

quality review at all levels (LGA, state,

national)

3.3.5 Develop SOP to address data quality

challenges (such as missing data, inconsistencies, updates on already submitted data)

3.3.6 Training of all management units on the

use of the data management software

3.3.7 Provide facility registers for all DOTS

facilities

Outputs:

3.3.1 M&E training curriculum

reviewed

3.3.2 # of persons trained on

TOT for M&E

3.3.3 # of LGTBLS and facility

staff trained on M&E

3.3.4 SOPs for data quality

review developed

3.3.5 SOPs for addressing data

quality challenges developed

3.3.6 # of program managers

trained on data management soft ware.

3.3.7 # of health facilities

provided with facility register



Objective 3.4

Develop a system and process for data

dissemination at all levels by 2015.

Data dissemination system and processes in place

Program progress report

Activities:

3.4 .1 NTBCLP stakeholders meeting, with the heads of ILEP partners, WHO, U.S. Government, and CDC Ips, to discuss policy on data dissemination

3.4.2 Develop policy document on data

dissemination

3.4 3 Printin g and distribution of the policy

document on data dissemination to all in-country partners

3.3.5 Monitor compliance of all in - partners with the policy on data dissemination, through tracking reports and communication products (e.g., newsletters and journals)

country

3.3.6 Produce quarterly TB newsletter

Output:

3.4.1 Stakeholders meeting held

3.4.2 Policy document on data

dissemination developed

3.4.3 # of copies of policy

document printed and distributed

3.4.5 # of TBL newsletters printed

quarterly

Objective 4

4.1 Increase and sustain the proportion of TB patients

tested for HIV from 62% in 2008 to at least 85% by end of 2015.

4.2 Ensure that at least 85% of TB/HIV co - infected patients receive CPT by 2015.

4.3 Ensure that at least 85% eligible TB/HIV co-

infected patients receive ARVs by 2015.

4.4 Establish infection control (IC) in all health

care facilities providing both DOTS and ART

services by 2015.

4.1 Proportion of TB patients

tested for HIV

4.2 Proportion of TB/HIV co -

infected patients on CPT

4.3 Proportion of TB/HIV co -

infected on ARVs

4.4 Number of health facilities with

IC plans

Quarterly and annual

case finding reports

Main activities:

4.1 Expand TB/HIV TWG to the remaining 14

states of Nigeria

4.2 Support quarterly meetings of TB/HIV

working groups (WGs) at national level

4.2B. Support quarterly meetings of TB/HIV

WGs at state level

4.3 Provide HCT in all DOTS treatment

centers.

4.4 Provide Cotrim for CPT to TB/HIV co-

infected personin all DOTS treatment centers

4.5 Procurement of HIV- test kits, IPT, CPT, ARVs, etc. (see PSM section)

4.6 Support facilities with both DOTS and ART services to develop an IC plan

4.7 Strengthen referral system between DOTS

and HIV sites

4.8 Other related activities: see PSM, HRD, and M&E sections

Outputs:

4.1 14 Additional states TB/HIV

TWG inaugurated

4.2 A. Quarterly meetings held at

national level

4.2 B. Quarterly meeting held at state level

4.3 HIV testing provided in all

DOTS treatment centers

4.4 Cotrim for CPT provided to

TB/HIV co-infected patients in all

DOTS treatment centers

4.6 IC plan available and implemented in all facilities with both DOTS and ART services

4.7 Referral instructions esta-blished between DOTS and HIV service delivery sites

linkages and


Strengthen TB/HIV collaborative activities

Objectives and activities MOV

patients reported on through routine surveillance system

5.2 Proportion of CAT 2 and

CAT 1 failures evaluated for MDR-TB

osed 5.3 Proportion of diagn

MDR-TB patients placed on 2nd line drugs

DRS report, monthly, quarterly, annual report.

Objective 5

5.1 Establish a routine

surveillance (DRS) system by end of

2011

5.2 Ensure that all CAT 2 failures have

access to lab diagnostic services for

MDR by end of 2012 and all CAT 1

failures by end of 2015

5.3 Provide 2nd line anti-TB drugs for at

least 85% of diagnosed MDR cases by

end of 2015

Main activities:

5.1. Support quarterly meeting of national MDR committee

5.2. A. Establish and support referral network

and transport logistics between peripheral health facilities/laboratories and the reference laboratories

5.2. B. Support referral/linkage of diagnosed or

confirmed MDR patients to treatment

centers for management with 2 -line drugsnd

5.3 Support cost for ancillary investigations

for all MDR-TB patients on treatment

Outputs:

5.1 MDR-TB quarterly meetings

held

5.2 A. Proportion of MDR

suspects whose sputum samples were transported to reference labs

5.2 B. Proportion of diagnosed

MDR-TB patients placed on treatment

5.3 Proportion of MDR-TB

patients supported for ancillary

investigations

5.4 Provide support and incentives/enablers

to all TB patients on treatment (e.g., bed fees, food packages, and transport cost and sustenance allowance).

5.5 Support the renovation of 2 treatment

center perzone for MDR treatment

5.6 2 line drugs and other commodities (see nd

section on PSM)

5.7 Facilitate linkage to Supra-NRL and support for annual external QA

5.8 Review QA guideline to include external

QA by Supra-National Reference Laboratories (see lab)

5.9 Conduct quarterly supervision to MDR

treatment centers

5.10 Conduct periodic DRS (by 2014)

5.11 Support weekly review meetings at MDR- TB treatment facilities

5.12 Provide TA for MDR-TB implementation (TA for Green Light Committee /drug

management, lab and programmatic/ clinical

mgt)

5.13 Issues on HRD, community involvement,

PSM: see appropriate section

5.4 Incentives/enablers provided

to MDR-TB patients

5.5 12 MDR-TB treatment

centers renovated

5.6 See section on PSM

5.7 Report of DRS available

5.8 See appropriate section

OVI

5.1 Number of MDR-TB

drug resistance


MDR-TB

Objectives and activities

Objective 6

Establish CTBC activities in at least 5

LGAs per state by end of 2015.

Number and proportion of

TB suspects referred to DOTs

facilities by Community

Volunteers/Treatment

Supporters (CV/TS)

Proportion of TB patients

receiving treatment from

CV/TS

finding report

Main activities:

6.1. Mapping of CSOs and CBOs in 36 states

and FCT (using existing supervisory system)

6.2 Organize and conduct a consensus

meeting with CSOs and CBOs on CTBC

activities

6.3 Conduct situation analysis and advocacy

visits to identified communities within the 5

selected LGAs

6.4 Establish appropriate linkage between

CTBC and the state programs using

appropriate RR forms

6.5 Identify and support 1 umbrella

CSO/CBO per state for implementation of

CTBC activities at community level.

6.6 Provide incentives and enablers for TS

and CVs

6.7 For RR formats, guidelines and trainings,

see appropriate section

6.6 Adoption and printing of community

based patient charter by CBOs and CSOs

Outputs:

6.1 List of CSOs and CBOs

available

6.2 Consensus meeting with

CSOs and CBOs held

6.3 Situation analysis and

advocacy conducted for 5 LGAs

6.4 RR for CTBC available

6.5 36 umbrella CSO/CBOs

identified and involved in CTBC

6.6 Appropriate incentives

provided to CVs/TS

Objective 7

7.1 Ensure budgetary allocation and

release of annual funds for TB and leprosy activities at all levels.

7.2 Improve community awareness of

TB and leprosy such that at least 60% of the public are aware of signs and

symptoms of TB and leprosy and TBL

service points by end 2015.

at national, state, and

LGA levels

7.2 Percentage of community

members with basic

knowledge of signs and

symptoms of TB and

leprosy

Number of states with CTBC

activities in 5 LGAs.

Annual report

Quarterly case

OVI MOV

Advocacy, Communication and Social Mobilization

7.1 Proportion of annually

planned budget released

Annual report


Engaging communities and patients in TB activities

Objectives and activities

Main activities:

7.1 Develop and print a comprehensive

ACSM framework

7.2A Support quarterly meeting of ACSM

committees at national Level

7.2B Support quarterly meeting of ACSM

committees at state levels

7.3 Organize annual advocacy visit to and state assembly

national

7.4 Support STOP TB Partnership, to carry

advocacy and conduct committee meetings

quarterly executive

7.5 Develop and produce appropriate specific advocacy kits and IEC materials for TB and leprosy control

context-

7.6 Organize national TB and leprosy conference biennially

7.7 Organize World TB and Leprosy Day

annually

7.8 Organize public awareness campaigns on TB and leprosy using appropriate channels quarterly at all levels (print, TV, and radio)

Outputs:

7.1 ACSM framework available

7.2 All states have ACSM

committees

7.3 ACSM quarterly meetings

held

7.4 Annual advocacy visits held

7.5 Stop TB partners supported

7.6 Appropriate IEC materials

available

7.7 TBL conference held bi-

annually

7.8 TB & leprosydays celebrated

7.9 Regular public awareness

OVI MOV

private, military, paramilitary, police, prisons, and custom health services, to contribute to at least 15% of total TB cases detected (excluding those from tertiary health institution) by the end of 2015

Quarterly report,

Annual report

paramilitary institutions.

Strategic alliances with academic, private, and other public practitioners

private, military, and

campaigns held

Objective 8

8.1 Scale up PPM services within the

8.1 Proportion of detected

TB cases attributable to


(HDL) to all tertiary health institutions by 2015

8.2 Number and proportion

of tertiary health institu-tions implementing HDL

8.2 Expand Hospital DOTS Linkage

8.1 Conduct a situation analysis and facility

assessment of military and paramilitary

health services in 36 states and FCT

8.2 Expand TB and TB/HIV services to additional

military, paramilitary, prisons and custom

health services, in providing DOTS (see DOTS expansion to additional facilities)

8.3 Renovate old (63) and newly identified

military and paramilitary facilities see DOTS

8.1 Situation analysis conducted

and facility assessment done

8.2 Additional military and

paramilitary health services

engaged in providing DOTS

8.3 Renovation of both old and

new military and paramilitary

health facilities including

customs and prison facilities


Main Activities:

8.4 Support quarterly national PPM steering

committee meetings

8.5 Support quarterly state PPM steering

committee meetings

8.6 Support monthly review meetings of DOTS

unit within HDL facilities

8.7 Support biannual meetings of the hospital

DOTS committee in the HDL facilities

8.8 Support mapping of professional associations and define roles in PPM See other HR, PSM, and DOTs expansion related activities in appropriate section

Outputs:

8.4 Quarterly national PPM

meeting conducted

8.5 Quarterly statePPM meeting

conducted

8.6 Monthly review meetings of DOTSunit within HDL facilities conducted

Objective 9.1

Reduce the rate of new cases with

grade-2 disabilities/100,000 population

by at least 35% by the end of 2015,

compared to the baseline at the end of

2010.

8.7 Bi-annual meetings of hospital

DOTS committee conducted

8.8 Mapping of professional

associations done

Leprosy

Grade-2 disability rate

/100,000 population

Annual case

finding report

Main activities:

9.1.1 Incorporate and integrate leprosy activities

into General Outpatient Department

(GOPD) /Skin/dermatology clinics through

integration of leprosy into secondary and

tertiary health facilities (stakeholders)

9.1.2 Conduct contact examination among all

new cases of leprosy

9.1.3 Identify and involve CVs and ex-leprosy

patients in a ppropriate leprosy activities in the community in high priority states and LGAs (150 LGAs in six states)

9.1.4 Engage private practitioners and traditional

healers in leprosy control services

Outputs:

9.1.1GOPDs/Skin/Dermatology

clinic in all LGA providing

leprosy services

9.1.2 Contact examination condu-cted among all index cases (MB)

9.1.3Leprosy community activities

in 150 high endemic

LGAs

9.1.4 Number of private practitioners involved in leprosy service

9.1.5 Organize special case finding activities in

difficult to reach areas (37 sites)

9.1.6 Community awareness, IEC, training and ACSM (see appropriate section)

9.1.5 Mini- LEC in 6 high

prevalence states


Objective 9.2

Sustain MB and PB treatment

completion rate of at least 85% and 95%

respectively th roughout the plan period.

Treatment completion rate

for MB and PB

Quarterly and

Annual reports

Main activities:

9.2.1 Provision of MDT and other related drugs (PSM)

Introduce adherence and counseling on MDT in leprosy program

Outputs:

9.2.1 Number of patients

provided with MDT

9.2.2 Adherence and counseling

session provided to all leprosy patients

9.2.2


9.2.3 Strengthen defaulter retrieval system

9.2.4 Provide patient support and enablers for referral

9.2.5 Training, curriculum review and supervision ( see HRD, M&E)

Objective 9.3

Ensure quality patient care such that proportion of patients who develop new/additional disabilities at the end of treatment is not more than 5% annually.

Proportion of new patients

with new disabilities

Main Activities:

9.3.1 Provide appropriate POID materials for

leprosy patients (e.g., Vaseline, shoes, eye glasses, crutches)

9.3.2 Provide adequate health education and counseling to all leprosy patients

9.3.3. Strengthen leprosy reaction management in the field

9.3.4 Expand and strengthen self-care groups in all leprosy settlements

Outputs:

9.3.1 Proportion of leprosy

patients provided with POID materials.

9.3.4 Number of leprosy patients

enrolled in self-care groups

Objective 9.4

Set up a systematic rehabilitation service aimed

at empowering leprosy patients using CBR

system in all states by end of 2015.

Number of states

implementing community

rehabilitation services (CBR)

Annual report

Main Activities:

9.4.1 Engage the services of a CBR expert

9.4.2 Develop a comprehensive rehabilitation services for leprosy patient based on CBR

9.4.4 Support the activity of IDEA annually

based on needs

Outputs:

9.4.1 CBR expert engaged

9.4.2 Comprehensive rehabilitation

available in all plan states

9.4.3 Link all PALs with umbrella organization of people living with disabilities in Nigeria

9.4.3 PALS links to umbrella

organization of people living with disabilities

9.4.4 IDEA’s activity supported

annually

9.4.5 Identify and equip 2 facilities for

9.4.5 Two facilities equipped to

carry out PRS preventive and rehabilitative surgery (PRS) (1 in South, 1 in North)


Objective 10

Develop capacity and environment for

research on TB, HIV and leprosy

among program managers at all levels. disseminated

Main activities:

10.1. TBL training institute to ally with academic institutions and other implemen-ting partners to set up research committee

10.2. Support bi-annual meeting of research

committee

Outputs:

10.1 Research team constituted

10.2 Research committee

meetings held

Research

Number of operational

researches conducted and

Objectives and activities MOV

10.3. Organize and conduct research training

workshops for program managers at different levels

10.4. Conduct situation analysis and develop

research agenda for TBL annually

10.5. Organize scholarship for presentations

of research findings at international

conferences

10.6. Support at least 6 researches annually

based on priorities and needs

10.7. Subscribe to international journals for all

program managers

10.8. Support the dissemination of research

findings in appropriate journals and newsletters

10.3 Six Health Service Research

(HSR) teams training conducted annually

10.4 Research agenda developed

10.5 Attendance at international conference with paper

presentation 10.6 Research activities conducted

by different group annually

10.7 Subscription and publications of research findings

Develop the management and

leadership capacity of program

managers at all levels by end of 2015.

# of program managers who had training on leadership andmanagement

Program annual report

Main activities:

11.1.1 Train at least 15 LG TB and leprosy

supervisors annually

11.1.2 Train at least 15 program managers on

TBL program management (including new initiatives) annually

11.1.3 Provide and maintain office space and

equipment including internet facility for

national, state, and local government control offices

11.1.4 Organize a training workshop for all

program officers on WHO costing tool (20 participants per year)

11.1.5 Support 12 participants for international

courses annually (Union, Sondalo, Bangkok, or other relevant courses)

11.1.6 Support at least 12 program officers toattend annual international conference on TB and leprosy

Outputs:

11.1.1 # of TBLS trained annually


trained annually

11.1.3 # of equipment supplied


trained on WHO costing tool

11.1.5 # of participants who

attended Sondalo course


who attend international course annually

HRD Objective 11.1

OVI


Objective 11.2

Ensure that the human resource needs of TB and leprosy at all levels are met

(recruitment, retention, motivation,

and tools).

# (%) of health facilities with at least one health worker trained on TB # (%) of posts filled according to HRD plan

Program annual

report

Activities:

11.2.1 Recruit and redeploy 10 medical

officers, 48 Nurses, 6 laboratory scientists, 2 pharmacists, 1 physiothe-rapist, and 10 medical lab technicians

Outputs:

11.2.1 # of staff recruited for

NTBLTC Zaria by carder


11.2.2 Recruit and train 2 maintenance officers

for both NRLs and ZRLs

11.2.3 Conduct leadership and management

course for at least 15 program officers twice yearly

11.2.2 2 Maintenance officers

recruited and trained


trained on leadership and management course per year

11.2.4 Train 4 national M&E officers and 2

state M&E officers per states on harmonized formats, data management and use of software (3 days training)

11.2.5 Provide monetary incentives to program

management staff at all levels

11.2.4 # of M&E officers trained

Objective 11.3 Develop and provide all program tools (guidelines, manuals and RR forms) for effective implementation of TB and Leprosy Control Program.

Activities:

Tools

11.3.1 Review, print, and disseminate the

NTBLCP Workers Manual (print 1000 annually)

11.3.2 Review and harmonize all training

materials (inclusion of TB/HIV, infection control, ISTC)

11.3.3 Print 8,000 copies of the TB training

module (1,600) copies annually

11.3.4 Review and harmonize all laboratory

guidelines and training modules to include HIV rapid testing

11.3.5 Print 4,000 copies of laboratory

training module (800 copies annually)

11.3.6 Develop a training module for

physicians/pediatricians on TB and leprosy

11.3.7 Print 2,500 copies of MO training module (500 copies annually)

11.3.8 Develop M&E training module

11.3.9 Print 2,5 00 copies of M&E training module (500 copies annually)

Outputs:

11.3.1 # of manuals printed

annually

11.3.2 Training materials

reviewed and harmonized

11.3.3 # of TB training modules

printed annually

11.3.4 Laboratory guidelines

reviewed and harmonized

11.3.5 # of laboratory manuals

printed

11.3.6 Training module for physicians/ pediatricians developed

11.3.7 # of MOs manual printed

11.3.8 M&E training module developed

11.3.9 # of M&E training modules printed


11.3.10 Develop training materials for PLHIV

support groups and community home-based care providers for TB/HIV

11.3.11 Review and finalize MDR-TB

management guideline (5-day workshop for 15 participants)

11.3.12 Print and distribute 1,000 copies of MDR-TB guidelines

11.3.13 Develop guidelines/protocol for routine

MDR- TB surveillance and finalization of RR for MDR-TB (12 participants)

11.3.11 MDR-TB management guideline developed

11.3.12 # of MDR- TB guidelines printed

11.3.13 Guideline and protocol

for MDR-TB survey developed

11.3.10 Training materials for

support group developedPLWHIV


11.3.14 Develop MDR-TB training module (5-day

workshop for 15 participants)

11.3.15 Develop and finalize SOPs for BSL3,

LED microscopy, Hain assay, and DST (15 participants)

11.3.16 16 Print and distribute 500 copies of

MDR-TB training module

11.3.17 Develop policy on TB patient support

11.3.18 Review and update leprosy training

modules (suspect/refer and leprosy management module)

11.3.19 Print and distribute 5,000 copies of

leprosy training modules (1,000 copies annually)

11.3.20 Review and harmonize all recording

and reporting formats

11.3.21 Printing and distribution of ALL

program recording and reporting formats, including IEC materials for TB and leprosy

11.3.22 Review of ALL program policy documents

and guidelines

based software for 11.3.23 Develop a web-

data management at all levels

11.3.24 Develop a national M&E country plan

11.3.25 Develop a procurement plan for TBL

commodities

11.3.26 Review and print LMIS recording and reporting formats

11.3.27 TOT workshops on the training tools

for each of the above stated tools; 30 participants each for DOTS, Microscopy, MDT TB, and leprosy training (30 *4)

3.14 MDR-TB training module

developed

3.15 SOPs for BSL3, LED and

Hain developed

3.16 # of SOPs developed

3.18 Leprosy training module

reviewed

11.3.19 # of leprosy training

modules printed

11.3.20 RR forms of program reviewed

11.3.21 IEC materials printed and

distributed

11.3.22 All program policy

documents reviewed

11.3.23 Web -based software

developed

11.3.24 M&E country plan developed

11.3.25 PSM plan developed

11.3.26 LMIS RR forms reviewed

11.3.27 # of personnel trained

forTOT

Objective 11.4 Empower health care workers to provide comprehensive TB and leprosy services, through training in all components of Stop TB strategy and enhance global strategy for leprosy.


General and TB

11.4.1 Conduct a 5-day training for lab staff

on AFB microscopy and QA (2 per lab for 1,247 additional labs)

11.4.2 Organize a refresher course for lab staff

(2/lab for 969 existing labs)

11.4.3 Organize and conduct 4-day training workshop for 3 GHCW per facility on DOTS for 2,346 additional DOTS centers (3 *2,346 = 7,038); each training session with a maximum of 25 participants and 3facilitators.

11.4.1 # of lab staff trained on

AFB and QA

11.4.2 # of lab staff who had

refresher course

11.4.3 # of GHCWs trained on

DOTS


11.4.4 Organize a 3-day refresher training for

national and state QA officers (15 participants annually)

Organize a 2-day training for physicians and pediatricians on TB management (6 participants per tertiary institution for 45 tertiary centers)Organize 3-day training for national and state logistic officers (4 national and 2 per state)

11.4.5 Organize a 3-day TOT workshop

among selected private practitioners (10 participants per zone)

11.4.6 Train 5 health care workers from each

selected (85% of prison health facilities)

prison health facility on TB DOTS

11.4.7 Organize a 2-day meeting annually to

develop a QA panel test kit

11.4.4 # of QA officers trained

11.4.5 # of private practitioners

who attended TOT

11.4.6 # of HCW in prison

trained on DOTS

11.4.7 # of meetings organized

on QA panel testing annually

PSM

11.4.8 Train and retrain health workers at all

levels on the LMIS tools

11.4.9 Train state teams on the use of patients

kits for treatment of TB

11.4.10 Train zonal pharmacists/store officers on

PSM and store management

11.4.11 Collaborate with JSI Deliver (USAID) to

institutionalize PSM training at NTBLTC

11.4.8 # of GHCWs trained on

LMIS

11.4.9 # of state TBL teams

trained on patient kits

11.4.10 # of zonal pharmacist/store officers trained on PSM

TB/HIV

11.4.12 Organize 5 -day training of GHW on

counseling and testing (3 GHWs per DOTS site for 2,742 sites)

11.4.13 One-day trainings of PLHIV and TB

patients on adherence (2 participants per site for 100 sites implementing TB/HIV collaborative activities annually).

11.4.14Organize 5 day training on “3 Is” -

(infection prevention and control, Intensify case finding and IPT) for health facilities providing TB and

11.4.12 # of GHWs trained on

HCT

11.4.13 # of support group

members trained on adherence

11.4.14 # of health workers

trained on 3 Is


TB/HIV collaborative activities (5 participants per site for at least 5 sites per state)

11.4.15 Organize 5-day training for PLHIV support groups and community home-based care providers for TB/HIV (4 participants per support group from 5 communities per LGA)

MDR-TB

11.4.16 Conduct 5 -day training for all

program managers on programmatic management of MDR-TB (including PSM personnel); 20 participants per course annually (20*5)


trained on MDR-TB

members trained on home based care

11.4.15 # of support group


11.4.17 Organize 5 -day training on MDR-TB for

physicians and nurses for MDR-TB management (2 MO, 6 nurses, 2 lab staff and 1 pharmacist, 2 social workers per center for 12 treatment centers)

11.4.18 Organize 2 weeks training for 4 -6 staff

of the 2 NRL and 6 ZRLs on culture and DST

11.4.19 Support study tour to countries with

functioning MDR-TB program for key program staff at national, state, and facility level (a team of 10 annually)

11.4.20 Organize training for CBOs and CSOs

on MDR- TB (support adherence for patients on treatment)

11.4.21 Support 2 TAs annually on MDR-TB

management

11.4.17 # of physician trained on

MDR-TB care

11.4.18 # of lab staff of NRL &

ZRL trained on culture and DST

11.4.19 # of participants who had

study tour

11.4.20 # of CBO,s & CSO,s

trained

CTBC

11.4.22 Organize a one-day sensitization training

for at least 4 participants per CSO 2 CSO per state

for

11.4.23 Organize 2-day training for 4 Cvs per

community for 5 communities per state (2*4*5* 37)

11.4.22 # of participants who

attended sensitization workshop

11.4.23 # of CVs trained

ACSM

11.4.24 Organize 5-day training for all program

managers on advocacy and lobby skills (25 participants per course for 2 courses)

11.4.25 Train selected journalists and CSO

stakeholders involved in TBL services on ACSM (20 participants per state for 37 states)


trained on ACSM

11.4.25 # of journalist trained on

TB ACSM


Leprosy

11.4.26 Organize a 1-day training on leprosy

suspect and referral for 3 GHWs per facility for 2 health facilities per LGA (3*2*774) for the period of 5 years

11.4.27 Organize a 3-day training on leprosy diagnosis and treatment for 3 Physicians/dermatologists for one secondary/tertiary health facility for 774 LGA (3*774)

11.4.28 Organize 3-day training on leprosy

for 3 GHWs per PHC for 2 PHC facilities in 150 high endemic LGAs (3*2*150)


leprosy suspect and referral


leprosy diagnosis and management

11.4.28 # of GHWs trained on leprosy


11.4.29 Organize 5-day training on community

dermatology for one site per state (4 participants per site: 4*37)

11.4.30 Organize 5-day training workshop for all

program officers and partners on rehabilitation based on CBR (30 participants per course for 2 course)

11.4.31 Train 2 selected surgeons and a

physiotherapist on preventive rehabilitative surgery for 2 zones (North/South); 2-3 months training at ALERT

11.4.32 Train CVs and ex-leprosy patients on

leprosy control activities in selected high endemic LGA (150 LGAs ); 2 days training for 4 participants per LGA

11.4.29 # of staff trained on

community dermatology

11.4.30 # of program officers

trained on CBR

11.4.31 # of surgeon trained on

leprosy surgery

11.4.32 # of ex-leprosy patients

trained on leprosy activities

Research

11.4.33 Recruit a focal person for research

for NTBLTC Zaria

11.4.34 Organize HSR training workshop for 6

teams (4-6 participants per team) annually, based on research agenda of the TBL program

11.4.33 Research focal person

appointed

11.4.34 # of participants trained

on HSR

Engagement with stakeholders

11.4.36 Support the integration of TBL control

activities into existing curriculum of pre-service training school

11.4.37 Develop a pool of facilitators within

academia and the private sector (organize TOT for 15 participants per zone)

11.4.35 Organize a stakeholders meeting

with professional bodies and heads of pre-service institutions on TBL control

11.4.35 Stakeholders meeting

organized

11.4.36 TBL activities integrated

into pre-service curriculum

11.4.37 # of staff in the academia

trained on TBL


Activities:

11.5.1 Organize a stakeholders meeting among

all partners on HIMS for HR

11.5.2 Develop and print HIMS for HR

11.5.3 Disseminates HIMS for HR for NTBLCP

to all stakeholders and at the control officers meeting.

11.5.1 Stakeholders meeting held

11.5.2 HIMS for HR developed

11.5.3 HIMS for HR discussed at

various meetings

Objective 11.5

Establish and maintain a health

information management system

(HIMS) for human resources for NTBLCP.

AN

NE

X

SM

AR

G

EB

: U

MY

BU

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TH

EM

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5T

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L$

valu

e

1L

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RO

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347,

605,

900

346,

196,

235

363,

506,

047

381,

681,

349

400,

765,

417

1,83

9,75

4,94

713

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2C

om

mu

nit

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(CT

BC

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5,03

2,50

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92,3

16,6

2693

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94,1

72,1

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6,16

3,70

83,

401,

169

4M

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luat

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075,

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900

796,

247,

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823,

526,

730

812,

252,

424

840,

079,

617

4,34

7,17

4,51

331

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5

Hu

man

Res

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ent

(HR

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2,07

4,89

7,83

82,

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609,

164

2,06

2,14

0,25

62,

093,

064,

669

2,10

3,58

9,27

610

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73,9

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6

Ad

voca

cy, C

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nic

atio

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cial

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315,

556,

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318,

711,

560

321,

898,

676

325,

117,

662

328,

368,

839

1,60

9,65

2,73

711

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7

Pro

cure

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ent

(PS

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1,71

0,26

0,32

31,

727,

362,

927

1,74

4,63

6,55

61,

762,

082,

922

1,77

9,70

3,75

18,

724,

046,

479

62,3

14,6

18

8T

B/H

IV C

olla

bo

rati

ve

107,

117,

100

108,

188,

271

109,

270,

154

110,

362,

855

111,

466,

484

546,

404,

864

3,90

2,89

2

9D

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403,

631,

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1,41

7,66

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431,

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187

1,44

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2,62

91,

460,

624,

255

7,15

9,92

9,78

351

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10

Mu

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gs

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nce

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ber

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sis

(MD

R)

1,76

7,32

7,00

01,

785,

000,

270

1,80

2,85

0,27

31,

820,

878,

775

1,83

9,08

7,56

39,

015,

143,

881

64,3

93,8

85

11L

abo

rato

ry1,

476,

506,

960

1,48

8,10

9,41

71,

502,

990,

511

1,51

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0,41

61,

533,

200,

620

7,51

8,82

7,92

353

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rch

242,

614,

300

245,

040,

443

247,

490,

847

249,

965,

756

252,

465,

413

1,23

7,57

6,76

08,

839,

834

TO

TAL

10,6

25,6

17,0

2210

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247,

490,

847

249,

965,

756

252,

465,

413

22,1

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12,2

3137

7,30

6,97

7

2010

- 2

015

TU

BE

RC

LO

SIS

AN

D L

EP

RO

SY

ST

RA

TE

GIC

PL

AN

SU

MM

AR

Y

16,650,000 17,482,500 18,356,625 19,274,456 20,238,179

ANNEX C: DETAILED BUDGET FOR EACH THEMATIC AREA

Leprosy section

Year 1 Year 2 Year 3 Year 4 Year 5

Objective Amount

To reduce the rate of new case with grade 2 disabilities/100,000m population by at least 35% by the end of 2015, compared to the base line at the end of 2009

B Incorporate and integrate Leprosy activities into GOPD/Skin/dermatology(clinics ( integration of leprosy into secondary and tertiary health facilities (organise a stakeholders meeting) 3,988,600 4,188,030 4,397,432 4,617,303 4,848,168

Conduct contact examination among all new cases of Leprosy 0 0 0 0 0

Identify and involve CVs and ex-leprosy patients in appropr-iate leprosy activities in the community in high priority states/LGAs (150 LGAs in 6 states) see HRD section 0 0 0 0 0

Engage private practi-tioners and traditional healers in Leprosy control services

3,988,600 0 0 0 0

Plan special case finding activities in difficult to reach areas (37 sites) 41,585,000 43,664,250 45,847,463 48,139,836 50,546,827

Community awareness, IEC, training and ACSM (see appropriate section) 0 0 0 0 0

Sub Total 49,562,200 47,852,280 50,244,894 52,757,139 55,394,996

Activities

To sustain MB and PB treatment comple-tion rate of at least 85% & 95% respec-tively throughout the plan period

Provision of MDT and other related drugs (PSM)

Introduce adherence and counseling on MDT in Leprosy program

Provide patient support and enablers for referral 611,000 641,550 673,628 707,309 742,674

To ensure quality patient care such that proportion of patients who develop new/additional disa-bilities at the end treatment is not more than 5% annually.

Provide appropriate POD materials for Leprosy patients (e.g Vaseline, shoes, eye glasses, crutches)

0 0 0 0 0

0 0 0 0 0

3,082,500 3,236,625 3,398,456 3,568,379 3,746,798

Provide adequate health education and counseling to all Leprosy patientsStrengthen Leprosy reaction management in the field

0 0 0 0 0

0 0 0 0 0

Expand & strengthen self care groups in all leprosy settlements

Sub total 16,650,000 17,482,500 18,356,625 19,274,456 20,238,179

8.1

8.2.

8.4.

8.3.

8.5.

8.6.

9.1.

9.2.

10.1.

10.2.

10.3.

10.4.

9.4.

2010 - 2015 TUBERCLOSIS AND LEPROSY STRATEGIC PLAN


Leprosy section


Objective AmountActivities

To set up a systematic rehabilitation service aim at empowering leprosy patients using community based rehabilitation system in all states by end of 2015

Engage the services of a CBR expert

9,785,000 10,274,25010,787,963 11,327,361 11,893,729

Develop a comprehensive rehabilitation services for Leprosy patient based on the concept of CBR

4,959,000 0 0 0 0

Link all PALs with umbrella organization of people living with disabilities in Nigeria

Support the activity of IDEA annually based on needs

1,000,000 1,050,000 1,102,500 1,157,625 1,215,506

Identify and equip 2 facilities for preventive and rehabilitative surgery (1 in South, 1 in North)

90,000,000 94,500,000 99,225,000 104,186,250 109,395,563

Sub total 105,744,000 105,824,250 111,115,463 116,671,236 122,504,797

Overall Total 347,605,900 346,196,235 363,506,047 381,681,349 400,765,417

0 0 0 00

11.1.

11.2.

11.3.

11.4.

11.5.




DOTS expansion

1.A To increase TB case detection rate from 30.5% in 2008 to 70% by 2015

Establish 2, 346 additional DOTS treatment centers

Support renovation of both old and new DOTS sites (i.e 5,088)

612,595,200 618,721,152 624,908,364 631,157,447 637,469,022


1.1

1.2

Establish 1,247 additional AFB microscopy centers

523,740,000 528,977,400 534,267,174 539,609,846 545,005,9441.3

Support renovation of both new and old labs (i.e 2,216)

217,168,000 219,339,680 221,533,077 223,748,408 225,985,8921.4

Completion of the reference laboratories (2 National and 6 Zonal laboratories)

44,800,000 45,248,000 45,700,480 46,157,485 46,619,060

Establish TB/HIV services in at least 70% of eligible PPM facilities by 2015

0 0

1.5

1.6

Scale up HDL plan in all tertiary health facilities by 2015 (quar-terly committee meetings)

5,328,000 5,381,280 5,435,093 5,489,444 5,544,3381.7

Establish DOTS services in at least 85% of Nigerian prisons

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1.8

Provide first line anti TB drugs,reagents etc (see obj 2 on PSM)

1.9

Training activities (refer to section on HRD)

1.10

Total 1,403,631,200 1,417,667,512 1,431,844,187 1,446,162,629 1,460,624,255




TB/HIV


4. A To increase and sustain the proportion of TB patients tested for HIV from 62% in 2008 to at least 85% by end of 2015

Expand TB/HIV TWG to the remaining 14 states of Nigeria

411,500 415,615 419,771 423,969 428,209

4.B To ensure that at least 85% of TB/HIV co-infected patients received CPT by 2015

A. Support quarterly meetings of TB/HIV Wgs at National level

2,040,000 2,060,400 2,081,004 2,101,814 2,122,832

4.C To ensure that at least 85% eligible TB/HIV co-infected patients received ARVs by 2015

Provide HIV (HCT) in all DOTS sites.

784,000 791,840 799,758 807,756 815,834

Provide CPT to TB/HIV co-in-fected person in all DOTS sites

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Procurement of HIV-test kits, IPT, CPT, ARVs etc See PSM section

Support facilities to develop an IC plan

103,881,600 104,920,416 105,969,620 107,029,316 108,099,610

Strengthen referral system between DOTS and HIV sites

Other related activities see PSM, HRD and M&E sections

4.1

4.2

4.3

4.4

4.5

4.6

4.7

4.8

107,117,100 108,188,271 109,270,154 110,362,855 111,466,484Total



PSM


To strengthen the existing PSM system in order ensure unin-terrupted drugs and commodities supply in all TBL facilities throughout the plan period

Renovation and annual maintenance of national, 6 zonal and 37 states stores

5,880,000 5,938,800 5,998,188 6,058,170 6,118,7522.1.

Procurement of both 1st and 2nd drugs for estimated number of patients

583,228,608 589,060,894 594,951,503 600,901,018 606,910,0292.2

Support commodities clearance and transport to different levels

0 0 0 0 02.3.

Procurement of laboratory reagents and consumables for 2, 216 laboratories

184,800,000 186,648,000 188,514,480 190,399,625 192,303,621

Procurement of reagents and other consumables for culture, DST and line probe assay for the two (2) national and 6 zonal reference laboratories.

3,101,120 3,132,131 3,163,453 3,195,087 3,227,038

Procurement and installation of equipments for the 2 national and six zonal laboratories.

123,200,000 124,432,000 125,676,320 126,933,083 128,202,414

2.4.

2.5.

2.6




PSM


Procurement of microscopes (light, LED and FM) for the additional laboratories as appropriate (1,247)

63,700,000 64,337,000 64,980,370 65,630,174 66,286,475

Procurement of INH for pro-phylaxis among children and PLHIV .

1,168,000 1,179,680 1,191,477 1,203,392 1,215,425

Procurement, installation and maintenance of X-ray machines at least one per state for diagno-sis of TB in children and EPTB

129,500,000 130,795,000 132,102,950 133,423,980 134,758,219

Procurement of Rifabutin for TB/HIV co-infected patients on 2nd line ARVs (estimate 2-5% of total TB cases)

2,253,079 2,275,610 2,298,366 2,321,349 2,344,563

Procurement of CPT for TB/HIV co-infected patients at DOTS centers (27-40% co-infection rate)

289,145,116 292,036,567 294,956,933 297,906,502 300,885,567

Procurement and support main-tenance of TB infection control equipments (N95 respirator, vaneometer, surgical mask etc)

121,094,400 122,305,344 123,528,397 124,763,681 126,011,318

Replacement and maintenance of project vehicles and motor-cycles at various levels.

196,520,000 198,485,200 200,470,052 202,474,753 204,499,500

Procurement of MDT & other drugs/POID materials for lep-rosy patients (using average of 5,000 patients annually).

0 0 0 0 0

2.7.

2.8.

2.9.

2.10

Plan quarterly meeting of TBL logistics TWG 6,670,000 6,736,700 6,804,067 6,872,108 6,940,829

2.11

2.12.

2.13.

2.14.

2.15.

1,710,260,323 1,727,362,927 1,744,636,556 1,762,082,922 1,779,703,751Total

Year 3 Year 4 Year 5

M&E workplan and budget 2010- 2015

Year 1 Year 2


To strengthen the M&E system at all levels in order line to ensure that over 95% planned activities are implemen-ted, monitored and evaluated in line with the National Strategic plan 2010-2015

Plan and conduct situation analysis to establish base line data for some of the program indicators.

1,992,500 0 0 0 0

Develop, produce and disseminate an indicator reference book for the NTBLCP

3,894,000 0 0 0 0

Conduct annual data audit on key Indicators

960,000 969,600 979,296 989,089 998,980

Conduct a stakeholders meeting for harmonization of work plans annually

3,245,000 3,277,450 3,310,225 3,343,327 3,376,760

Develop annual work plans with a costed budget at national level

235,000 237,350 239,724 242,121 244,542

Plan and conduct quarterly meetings at zonal levels, including EQA.

48,492,000 48,976,920 49,466,689 49,961,356 50,460,970

Plan and conduct quarterly meetings at states levels

263,125,200 265,756,452 268,414,017 271,098,157 273,809,138



Year 1 Year 2


Plan and conduct planning cell meetings quarterly

7,380,000 7,453,800 7,528,338 7,603,621 7,679,658

Plan and conduct annual program review meeting with state program officers and partners

12,305,000 12,428,050 12,552,331 12,677,854 12,804,632

Conduct mid and end term evaluation of the TBL strategic plan

0 9,861,307 10,059,519

Plan and conduct biennial programme monitoring and periodic evaluation (JIMM)

9,268,800 0 9,455,103 0 9,645,150

Plan and conduct program integ-rated supervision to all TBL health facilities monthly by LG TBLS

216,720,000 218,887,200 221,076,072 223,286,833 225,519,701

Plan and conduct program integra-ted supervision to all LGAs quarterly by STBLCO

145,145,000 146,596,450 148,062,415 149,543,039 151,038,469

Plan and conduct integrated supervision from national/zonal to at least 12 states per quarter

38,304,000 38,687,040 39,073,910 39,464,650 39,859,296

Plan and conduct program integra-ted supervision to all states quarterly by TB NPO's

20,905,000 21,114,050 21,325,191 21,538,442 21,753,827

Support CU Zonal coordinators to provide technical assistance through supportive supervisory visits to 3 states per quarter

22,104,000 22,325,040 22,548,290 22,773,773 23,001,511

Conduct monthly coordination meeting at central unit level

1,320,000 1,333,200 1,346,532 1,359,997 1,373,597

Sub Total 795,395,500 788,042,602 815,239,438 803,882,258 831,625,750



Year 1 Year 2


To institute and stre-ngthen electronic data management system at all levels (facilities, LGAs, States and National)

Identify and engage a TA for the development of a database for NTBLCP

450,000 0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Conduct situation analysis, inventory and IT assessment at the National, States and LGA levels for M&E

1,604,000

Develop IT specification for IT requirements at all levels

717,000

Develop a suitable software for data management at all levels

450,000

Procure and Distribute IT infrastruc-ture to all the points of need at all levels (including laptops)

131,200,000

Support maintenance of the IT sup-portive structures/ National website

6,624,000 6,690,240 6,757,142 6,824,714 6,892,961

Provision of regular feedbacks on completeness and quality of data transmitted at all levels

Sub Total 141,045,000 6,690,240 6,757,142 6,824,714 6,892,961

0





Year 1 Year 2


To build capacities in M&E, Strategic Infor-mation and Data management for the program at all levels (health facilities, LGAs, States and National) by 2015

Review the National M&E training curriculum/module

560,500 0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Plan a Training of trainers for the M&E course

2,850,200

Train all the LGA TBLS on M&Es and Health Facilities

119,332,300

Develop SOP and checklists for data quality review at all levels (LGA, State, National)

1,542,200

Develop SOP for addressing data quality challenges ( such as missing, inconsistencies, updates on already submitted data)

1,061,300

Training of all Management units onthe use of the data management software

5,732,100

Provide facility registers for all DOTS facilities

3,052,800

Sub-Total 134,131,400

00 00 00 00



Year 1 Year 2


To develop a system and process for data dissemination at all levels by 2015

NTBLCP hold Stakeholders meeting with the Heads of ILEP partners, WHO, USG, USG and CDC IPs to discuss policy on data dissemination

977,500

Develop Policy document on data dissemination

1,568,500

Printing and distribution of the policy document on data dissemination to all in-country partners

450,000

Monitor compliance of all in-country partners to the policy on data dissemination through tracking of reports and communication products (e.g. Newsletters and Journals)

Produce Quarterly TB newsletter 1,500,000 1,515,000 1,530,150 1,545,452 1,560,906

Sub Total 4,496,000 1,515,000 1,530,150 1,545,452 1,560,906

OVERALL TOTAL 1,075,067,900 796,247,842 823,526,730 812,252,424 840,079,617

0

0

0

0

0

0

0

00

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0




To strengthen and expand quality labo-ratory services such that one lab will serve a population of at least 80,000 in Nigeria

Establish 1,247 addition AFB microscopy centers 523,740,000 528,977,400 534,267,174 539,609,846 545,005,944

Support renovation of both new and old labs (i.e 2,216)

217,168,000 219,339,680 221,533,077 223,748,408 225,985,892

Completion of the reference laboratories (2 National and 6 Zonal laboratories)

44,800,000 45,248,000 45,700,480 46,157,485 46,619,060

Procurement of laboratory reagents and consumables for 2, 216 laboratories (see PSM)

184,800,000 186,648,000 188,514,480 190,399,625 192,303,621

Procurement of reagents and other consumables for culture, DST and line probe assay for the two (2) national and 6 zonal reference laboratories.

3,101,120 3,132,131 3,163,453 3,195,087 3,227,038

Procurement and installation of equipments for the 2 national and six zonal laboratories.

123,200,000 124,432,000 125,676,320 126,933,083 128,202,414

Procurement of microscopes (light, LED and FM) for the additional laboratories as appropriate (1,247)

63,700,000 64,337,000 64,980,370 65,630,174 66,286,475

Conduct a 5 day training for lab staff on AFB microscopy and QA (2 per lab for 1,247 additional labs)

106,237,720 107,300,097 108,373,098 109,456,829 110,551,397

Maintenance of 6ZRL and 2 NRL

31,600,000 31,916,000 32,235,160 32,557,512 32,883,087

Provide 36 KVA battery operated inverters and 10,000 volts UPS for the 2 national reference laboratories.

6,050,000 6,110,500 6,171,605 6,233,321 6,295,654

Review/update of draft national guidelines on QA- culture/DST, SOPs and FM including safety

3,131,300 0 0 0 0

Print and disseminate 3,000 copies of the finalized national guidelines on QA- culture/DST, SOPs on FM

360,000 363,600 367,236 370,908 374,617

Train all the 37 SLFP on quality assured FM (see HRH)

0 0 0 0

Develop, print and disseminate 3,000 copies of quality and safety manual

2,924,400 2,953,644 2,983,180 3,013,012 3,043,142

Identify and support training of 22 Medical laboratory scientist/Technicians safety officers in all facilities at all levels (see HRD)and central unit.

4,000,000 4,040,000 4,080,400 4,121,204 4,162,416

Training of laboratory data management staff at National and Reference laboratory

3,130,200 3,161,502 3,193,117 3,225,048 3,257,299

Provide and install communication gadget, unit computer system with internet connection for 6 zonal and 2 national reference laboratories

2,432,000 2,456,320 2,480,883 2,505,692 2,530,749

LABORATORY

1.3

1.4

1.5

2.4.

2.5.

2.6

2.7.

4.1.


Total



Train and retrain 2 NRL, 6ZRL, 37 SRL and 6 laboratory staff from the central unit on QA procedures, QA data management and utilization

106,237,720 107,300,097 108,373,098 109,456,829 110,551,397

Organize and conduct Lab TWG meeting quartertly

652,500 659,025 665,615 672,271 678,994

750,000 757,500 765,075 772,726 780,453Laboratory facilty tour from NRL, Zonal reference lab and NTBLCP

48,492,000 48,976,920 49,466,689 49,961,356 50,460,970Plan and conduct quarterly meetings at zonal levels, including EQA.

1,476,506,960 1,488,109,417 1,502,990,511 1,518,020,416 1,533,200,620

Plan and conduct lab supervision to National and Reference twice a year from CU (see M&E)

0 0 0 0 0

LABORATORY



MDR


5.A. To establish a routine drug resistance surveillance system by end of 2011

Support quarterly meeting of MDR committee

9,635,000 9,731,350 9,828,664 9,926,950 10,026,2205.1.

5.B. To ensure that all CAT 2 failures have access to lab diagno-stic services for MDR by end of 2012 and all CAT 1 failures by end of 2015

A. Establish and support referral network and transport logistics between peripheral health facilities/laboratories and the reference laborato-ries/treatment centers.

10,200,000 10,302,000 10,405,020 10,509,070 10,614,1615.2

5.C. To provide 2nd line anti-TB drugs for at least 85% of diag-nosed MDR cases by end of 2015

B. Support referral/linkage of diagnosed or confirmed MDR patients to treatment centres for management with 2nd-line drugs

3,720,000 3,757,200 3,794,772 3,832,720 3,871,0475.2

Support cost for ancillary investigations for all MDR TB patients on treatment

15,500,000 15,655,000 15,811,550 15,969,666 16,129,3625.3.

Provide support and incentives/enablers to all TB patients on treatment (e.g bed fees, food packages, and transport cost and sustenance allowance).

1,002,100,000 1,012,121,000 1,022,242,210 1,032,464,632 1,042,789,2785.4.

2nd line drugs and other com-modities see section PSM

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Support the renovation of 2 treatment center per zone for MDR treatment

720,000,000 727,200,000 734,472,000 741,816,720 749,234,887

Facilitate linkage to Supra-NRL and support for annual EQA

5.5.

5.6.

5.7.

Review QA guideline to include EQA by SNRL (see lab)

Conduct quarterly supervision to MDR treatment centres

880,000 888,800 897,688 906,665 915,732

5.8

5.9

Conduct periodic DRS (by 2014)

5.10




MDR


Provide TA for MDR-TB imple-mentation (TA for GLC/Drug management, Lab and Programmatic/clinical mgt)

2,700,000 2,727,000 2,754,270 2,781,813 2,809,631

Support monthly review meetings at MDR-TB treatment facilities

2,592,000 2,617,920 2,644,099 2,670,540 2,697,246

Total 1,767,327,000 1,785,000,270 1,802,850,273 1,820,878,775 1,839,087,563

5.11

5.12



CTBC

To establish CTBC activities in at least 5 LGAs per state by end of 2015

Mapping of CSOs and CBOs in 36 states and FCT 0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Plan and conduct a consensus meeting with CSOs and CBOs on CTBC activities

5,027,500 5,077,775 5,128,553 5,179,838 5,231,637

Conduct situation analysis and advocacy visits to identified communities within the 5 selected LGAs

12,580,000

Establish appropriate linkage between CTBC and the state programs using appropriate R&R forms

Identify and Support 1 umbrella CSO/CBO per state for imple-mentation of CTBC activities at community level.

17,632,500 17,808,825 17,986,913 18,166,782 18,348,450

Provide incentives and enab-lers for TS and CVs

66,600,000 67,266,000 67,938,660 68,618,047 69,304,227

For R&R formats, guidelines and trainings (see approporiate section)

Adoption and printing of com-munity based Patient charter by CBOs and CSOs

3,192,500 1,250,000 1,262,500 1,275,125 1,287,876

6.1.

6.2.

6.3

6.4.

6.5.

6.6.

6.7.

6.8

Total 105,032,500 91,402,600 92,316,626 93,239,792 94,172,190



ACSM


7.A. To ensure budg-etary allocation and release of annual fun-ds for TB and leprosy activities at all levels

Develop a comprehensive ACSM plan

3,682,500 3,719,325 3,756,518 3,794,083 3,832,0247.1.

7.B. To improve comm-unity awareness on TB and Leprosy such that at least 60% of the public are aware of signs and symptoms of TB and Leprosy and service points by end 2015

A Support Quarterly meeting of ACSM committees at National quartely

2,580,000 2,605,800 2,631,858 2,658,177 2,684,7587.2.





ACSM

B Support Quarterly meeting ofACSM committees at all states

64,010,000 64,650,100 65,296,601 65,949,567 66,609,063

Plan annual advocacy visit to National and state assembly

19,055,000 19,245,550 19,438,006 19,632,386 19,828,709

Support STOP TB Partnership to carry advocacy and conduct quarterly executive meetings

1,552,000 1,567,520 1,583,195 1,599,027 1,615,017

7.2.

7.3.

7.4.

Develop appropriate context specific advocacy kits and IEC materials for TB and Leprosy control

3,082,500 3,113,325 3,144,458 3,175,903 3,207,662

Plan TB and Leprosy conference biennially

24,410,000 24,654,100 24,900,641 25,149,647 25,401,144

Plan World TB and Leprosy Day annually

27,980,000 28,259,800 28,542,398 28,827,822 29,116,100

Plan public awareness camp-aigns on TB and Leprosy using appropriate channels quarterly at all levels ( print, TV and radio

169,204,000 170,896,040 172,605,000 174,331,050 176,074,361

7.5.

7.6.

7.7.

7.8.

Total 315,556,000 318,711,560 321,898,676 325,117,662 328,368,839



RESEARCH

To develop capa-city and environ-ment for researchon TB, HIV and leprosy among program mana-gers at all levels.

TBL training institute to ally with academic institutions and other implementing partners in areas of research to set up research committee

9,872,000 9,970,720 10,070,427 10,171,131 10,272,843 10,375,571

Support bi-annual meeting of research committee ( Emphasison 14.1)

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Plan and conduct res-earch training work-shops for program managers at different levels

187,217,300 189,089,473 190,980,368 192,890,171 194,819,073 196,767,264

Conduct situation analysis and develop research agenda for TBL annually

Plan scholarship for pres-entations of research findings at international conferences

13,200,000 13,332,000 13,465,320 13,599,973 13,735,973 13,873,333

Support the conduct of at least 6 researches ann-ually based on priorities and need

31,200,000 31,512,000 31,827,120 32,145,391 32,466,845 32,791,514

Subscribe internationaljournals for all programme managers

1,125,000 1,136,250 1,147,613 1,159,089 1,170,680 1,182,386

Support the dissemination of research findings in appropriate journals and newsletters

Total 242,614,300 245,040,443 247,490,847 249,965,756 252,465,413 254,990,068

12.1.

12.2.

12.3.

12.4.

12.5.

12.6.

12.7.

12.8.






Train at least 15 LG TB and Leprosy supervisors annually

3,750,000 3,787,500 3,825,375 3,863,629 3,902,265To develop the management and leaderrship capacity of programme managers at all levels by 2015

Training of at least 15 program managers on TBL program management (including new initiatives) annually.

8,103,200 8,184,232 8,266,074 8,348,735 8,432,222

Provide and maintain office space, equipment including internet facility for national, state and local government control offices

0 0 0 0 0

Organize a training workshop for all program officers on WHO costing tool (20 participants per year)

16,762,400 16,930,024 17,099,324 17,270,317 17,443,021

Support 12 participants forinternational courses annually (Union, Sondalo, Bangkok or other relevant courses)

3,750,000 3,787,500 3,825,375 3,863,629 3,902,265

Support at least 12 program officers to attend annual international conference on TB and Leprosy

2,250,000 2,272,500 2,295,225 2,318,177 2,341,359

Sub total 34,615,600 34,961,756 35,311,374 35,664,487 36,021,132

1.1

HRD


1.2

1.3

1.4

1.5

1.6



HRD


Objective 2: To ensure that the hu-man resource need of TB and leprosy at all levels are met. (Recruitment, reten-tion, and motivation)

Recruit and redeploy 10 medical officers, 48 nurses, 6 laboratory scientists, 2 pharmacists, physiotherapist and 10 medical lab technicians

0 0 0 0 0

Recruit and train 2 maintenance officers for both NRLs and ZRLs

62,160,000 62,781,600 63,409,416 64,043,510 64,683,945

Conduct leadership and mana-gement course for at least 15 program officers twice yearly

9,126,700 9,217,967 9,310,147 9,403,248 9,497,281

Train 4 national M & E officers and 2 state M & E officers per states on Harmonized formats, data management and use of soft ware (3 days training)

4,124,700 4,165,947 4,207,606 4,249,683 4,292,179

2.1

2.2

2.3

2.4

Provide monetary incentives to program management staff at all levels

12,000,000 12,120,000 12,241,200 12,363,612 12,487,248

Plan a stakeholders meeting with professional bodies and heads of pre-service institutions on TBL control

8,120,000 8,201,200 8,283,212 8,366,044 8,449,705

2.5

2.6




HRD


Support the integration of TBL control activities into existing curriculum of pre-service training school

0 0 0 0 0

Develop a pool of facilitators within the academia and private sector ( Plan TOT for 15 participants per zone)

20,923,800 21,133,038 21,344,368 21,557,812 21,773,390

Sub total 116,455,200 117,619,752 118,795,950 119,983,909 121,183,748

2.7

2.8



HRD


Objective 3; To develop and provide all program tools (guidelines, manuals and R&R forms) for effective implementa-tion of TB and Lepro-sy Control Programme

Review, print and disseminate the NTBLCP Workers Manual (Print 1000 annually)

3,930,000 3,969,300 4,008,993 4,049,083 4,089,574

Review and harmonize all training materials (inclusion of TB/HIV, infection control, ISTC)

3,930,000 0

0

0

0

0

0

0

0

Print 8,000 copies of the TB training module (1,600) copies annually

720,000 727,200 734,472 741,817 749,235

Review and harmonize all laboratory guidelines and training modules to include HIV rapid testing and safety

3,131,300

Print 4,000 copies of laboratoryguidelines and training module (800 copies annually)

360,000 363,600 367,236 370,908 374,617

3.1

3.2

3.3

3.4

3.5

Develop guidelines/protocol for routine MDR TB surveilla-nce and finalization of R & R for MDR TB (12 participants

3,852,000

Print and distribute 1,000 copies of MDR TB guidelines

450,000 454,500 459,045 463,635 468,272

Review and finalized MDR TB management guideline (5 days workshop for a group of 15 participants)

3,852,000

Develop training materials for PLHIV support groups and community home based care providers for TB/HIV.

2,846,000

Print 2,500 copies of M & E trai-ning module (500 copies annually)

225,000 227,250 229,523 231,818 234,136

Develop M & E training module 2,846,000

Printing laminated copies of score chart for children diagnosis of TB

100,000 101,000 102,010 103,030 104,060

Print 2,500 copies of MO training module and (500 copies annually)

225,000 227,250 229,523 231,818 234,136

Develop a training module for physician/pediatrician on TB and Leprosy

3,107,500 0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

3.6

3.7 a

3.7b

3.8

3 9

3.10

3.11

3.12

3.13




HRD


Develop MDR TB training module (5 days workshop for a group of 15 participants)

3,852,000 0 0 0 03.14

Develop and finalize SOPs for BSL3, LED microscopy, HAIN assay and DST (15 participants)

2,946,000 0 0 0 0

Print and distribute 500 copies of MDR TB training module

225,000 227,250 229,523 231,818 234,136

Review and update leprosy training modules (suspect/refer and leprosy management module)

2,123,000 0 0 0 0

Print and distribute 5,000 cop-ies of Leprosy training modules (1,000 copies annually)

450,000 454,500 459,045 463,635 468,272

Review and harmonize all recording and reporting formats

2,123,000 2,144,230 2,165,672 2,187,329 2,209,202

Printing and distribution of ALL program recording and reporting formats including IEC materials for TB and Leprosy

1,250,000

1,250,000

1,262,500

1,262,500

1,275,125

1,275,125

1,287,876

1,287,876

1,300,755

1,300,7553Review of ALL program policy documents and guidelines

Develop a web based soft ware for data management at all levels

10,000,000 0 0 10,303,010 0

Develop a national M & E country plan

2,967,000

Develop a procurement plan for TBL commodities

2,967,000

Review and print LMIS recording and reporting formats

1,250,000

TOT workshops on the training tools for each of the stated tool above; 30 participants each for DOTS, Microscopy, MDT TB and Leprosy training (30 *4)

26,846,000 0 27,385,001 27,658,851 27,935,440

Sub total 86,573,800 10,158,580 37,645,167 48,324,628 38,401,835

3.15

3.16

3.18

3.19

3.20

3. 21.

3.22

3.23

3.24 0

0

0

0

0

0

0

0

0

0

0

0

3.25

3.26

3.27





To empower health care workers to provide a compre-hensive TB and Leprosy services through training in all components of Stop TB strategy and enhance global strategy for leprosy.

Conduct a 5 day training for lab staff on AFB microscopy and QA (2 per lab for 1,247 additional labs)

106,237,720 107,300,097 108,373,098 109,456,829 110,551,3974.1.

HRD




Days training of PLHIV and TB patients on adherence (2 participants per site for 100 sites implementing TB/HIV collaborative activities annually.

44,785,600 45,233,456 45,685,791 46,142,648 46,604,075

Plan 5 day training on 3Is (infectionprevention and control, Intensify case finding and IPT) for health facilities providing TB and TB/HIV collaborative activities (5 partici-pants per site for at least 5 sites per state)

203,433,400 205,467,734 207,522,411 209,597,635 211,693,612

Plan and conduct 4 day training workshop for 3 GHCW per facility on DOTS for 2,346 additional DOTS centers (3 *2,346 = 7,038) each training session for maximum of 25 participant and 3 facilitators.

211,785,120 213,902,971 216,042,001 218,202,421 220,384,445

Plan a refresher course for lab staff (2/lab for 969 existing labs)

84,255,360 85,097,914 85,948,893 86,808,382 87,676,465

Train state teams on the use of patients kits for treatment of TB

17,125,700 17,296,957 17,469,927 17,644,626 17,821,072

Train and retrain health workers at all levels on the LMIS tools

140,612,800 142,018,928 143,439,117 144,873,508 146,322,244

Train 5 health care workers from each selected prisonhealth facilities on TB DOTS (85% of prison health facilities)

12,468,800 12,593,488 12,719,423 12,846,617 12,975,083

Plan a 3 day TOT workshop among selected private practitioners (10 participants per zone)

10,127,100 10,228,371 10,330,655 10,433,961 10,538,301

Plan a 2 day training for phy-sician and pediatrician on TB management (6 participants per tertiary institution for 45 tertiary centers)

34,918,700 35,267,887 35,620,566 35,976,772 36,336,539

Plan a 3 day refresher training for national and state QA officers (15participants annually)

3,451,200 3,485,712 3,520,569 3,555,775 3,591,333

4.2

4.3

4.4

4.5

4.6

4.7

4.8

4.9

Train zonal pharmacists/store officers on PSM and store management

1,950,200 1,969,702 1,989,399 2,009,293 2,029,386

Collaborate with JSI Deliver to institutionalize PSM training at NTBLTC

0 0 0 0 0

Plan 5 day training of GHW on counseling and testing (3 GHWs per DOTS site for 2,742 sites)

334,947,080 338,296,551 341,679,516 345,096,311 348,547,275

4.10

4.11

4.12

4.13

4.14

Plan 5 days training for PLHIV support groups and community home based care providers for TB/HIV. (4 participants per support group from 5 communities per LGA)

70,407,000 71,111,070 71,822,181 72,540,403 73,265,8074.15


HRD




Plan 2 weeks training for 4-6 staff of the 2 NRL and 6 zonal Rls on culture and DST

8,428,400 8,512,684 8,597,811 8,683,789 8,770,627

Plan 5 day training on MDR TB for physician and nurses for MDR TB management (2 MO, 6 nurses, 2 lab staff and 1 pharmacist, 2 social workers per centre for 12 treatment centers)

37,249,100 37,621,591 37,997,807 38,377,785 38,761,563

Conduct 5 day training for all program managers on progra-mmatic management of MDR TB (including PSM personnel) 20 participants per course annually (20*5)

4,813,700 4,861,837 4,910,455 4,959,560 5,009,1564.16

4.17

4.18

Train identified Journalist and CSO stakeholders involved in TBL services on ACSM (20 participants per state for 37 states)

162,026,000 163,646,260 165,282,723 166,935,550 168,604,905

Plan 5 day training for all pro-gram managers on advocacy and lobby skills (25 particip-ants per course for 2 courses)

6,281,400 6,344,214 6,407,656 6,471,733 6,536,450

Plan 3 day training on leprosy for 3 GHWs per PHC for 2 PHC facilities in 150 high endemic LGAs. ( 3*2*150)

13,670,100 13,806,801 13,944,869 14,084,318 14,225,161

Plan a 3 day on leprosy diag-nosis and treatment for 3 Physician/dermatologist for one secondary/tertiary health facility for 774 LGA (3*774)

17,950,700 18,130,207 18,311,509 18,494,624 18,679,570

Plan a 1 day training on leprosy suspect and referral for 3 GHWs per facility for 2 health facilities per LGA (i.e 3 *2*774) for the period of 5 years

6,672,600 6,739,326 6,806,719 6,874,786 6,943,534

Plan 2 day training for 4 CVs per community for 5 commu-nities per state (2*4*37)

5,888,200 5,947,082 6,006,553 6,066,618 6,127,285

Plan a one day sensitization training for at least 4 partici-pants per CSO for 2 CSO per state

7,801,200 7,879,212 7,958,004 8,037,584 8,117,960

Support 2 TAs annually on MDR TB management

1,700,000 1,717,000 1,734,170 1,751,512 1,769,027

Plan training for CBOs and CSOs on MDR TB (support adherence for patients on treatment)

0 0 0 0 0

Support study tour to countries with function MDR TB program for key program staff at national, state and facility level (a team of 10 annually)

7,900,000 7,979,000 8,058,790 8,139,378 8,220,7724.19

4.20

4.21

4.22

4.23

4.24

4.25

4.26

4.27

4.28

Plan 5 day training on commu-nity dermatology for one site per state (4 participants per site) 4*37

34,365,400 34,709,054 35,056,145 35,406,706 35,760,7734.29


HRD




Plan HSR training workshop for 6 teams (4-6 participants per team) annually based on research agenda of the TBL program

187,217,300 189,089,473 190,980,368 192,890,171 194,819,073

Recruit a focal person for research for NTBLTC Zaria

0 0 0 0 0

Train CVs and ex-leprosy patients on leprosy control activities in selected high endemic LGA (150LGAs ) 2 days training for 4 participants per LGA

26,162,700 26,424,327 26,688,570 26,955,456 27,225,011

Train 2 identified surgeon and a physiotherapist on preven-tive rehabilitative surgery for 2 zones (North/South) 2-3 months training at ALERT

4,100,000 4,141,000 4,182,410 4,224,234 4,266,476

Plan 5 days training workshop for all program officers and partners on rehabilitation based on CBR (30 participants per course for 2 course)

14,231,100 14,373,411 14,517,145 14,662,317 14,808,940

Sub total 1,822,963,680 1,841,193,317 1,859,605,250 1,878,201,302 1,896,983,315

Using expected 5% attrition rate of trained staff. 1,832,078,498 1,850,399,283 1,868,903,276 1,887,592,309 1,906,468,232

4.30

4.31

4.32

4.33

4.34




Objective 5: To establish and main-tain health informa-tion management system for human resource for NTBLCP

Organize a stakeholders meeting among all partners on HIMS for HR

2,587,500 0

0

0

0

0

0

0

0

0

0

0

0

Develop and print HIMS for HR

1,955,000

Disseminates HIMS for HR forNTBLCP to all stakeholders and at the control officers meeting.

Sub Total 4,542,500

Overall Total 2,074,265,598 2,013,139,371 2,060,655,766 2,091,565,334 2,102,074,947

5.1

5.2

5.3 0


HRD

HRD

0 0 0 0

the national strategic plan for tuberculosis and leprosy control

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